Lecture-2

Heart

Assignment on Heart
1. Draw and label pulmonary and systemic circulation.
2. Draw and label conducting system of Heart.
3. Draw and label the artery supply of Heart.

20-2

Size, Shape, Location of the Heart

Size of a closed fist
Shape:-Apex: Is located deep to the
left fifth intercostal space, approx. 7-9 cm
to the left of the sternum and medial to
the mid -clavicular line.
-Base: posteriorly and to the right.

Located in thoracic cavity in

mediastinum (central core of the
thoracic cavity)
Important clinically when using a
stethoscope, performing an ECG, or
performing CPR

20-3

Covering of Heart- Pericardium

2 layers of it

Fibrous Pericardium
(outer layer)

Serous (Visceral) Pericardium-(inner)

Attached to heart

Heart Wall

Formed by three layers : From

outer to inner Epicardium: Serous
membrane; smooth outer
surface of heart. This is
visceral pericardium.
Myocardium: Middle layer
.composed of cardiac
muscle and responsible for
heart contraction. Thickest
layer.
Endocardium: Smooth inner
surface , covers heart
chambers.
Trabeculae carnae: muscular
ridges and columns on inside
walls of ventricles

Simple squamous
epithelium
Loose connective
tissue and
adipose tissue

Epicardium
(visceral
pericardium)

Myocardium

Endocardium

Trabeculae
carneae

20-5

Heart muscles

Papillary muscle

Papillary muscles: Muscles

present in left ventricle.

Pectinate muscle

Pectinate muscles: muscles

present in auricles and right
atrium.
20-6

Heart Wall- 3 layers

Epicardium

Myocardium(cardiac muscle
present)

Endocardium

20-7

Heart Wall-3 layers

Epicardium
Myocardium

Endocardium

Heart Chambers
Heart has 4 chambers.
1. 2 atrium above- Right and Left. They are
separated by interatrial septum
2. 2 ventricles below- Right and Left .They are
separated by interventricular septum.
Between 2 atria and 2 ventricles atrioventricular line present.
From atrium to ventricle, blood comes through
Av orifice (opening).

Right Atrium

Right Ventricle

Heart Chambers

Left Atrium

Left Ventricle

Heart Chambers -posterior

Rt. Atrium

Rt. Atrium

Lt. Atrium
Lt. Atrium

Rt. Ventricle

Lt. Ventricle
Lt. Ventricle

Rt. ventricle

Septum of Heart

Inter atrial septum

Inter ventricular septum

Rt. Atrium

Rt. ventricle

4 Chambers of heart (interior)

Lt. Atrium

Lt. ventricle

Chambers and blood

Rt. atrium: contains deoxygenated ( co2)
blood-Comes from whole body and heart also.
Rt. ventricle: contains deoxygenated blood,
comes from rt. Atrium
Lt. atrium: Contains Oxygenated blood ,
comes from Two lungs
Lt. ventricle: Contains Oxygenated blood ,
comes from lt. atrium.

 In rt. atrium: deoxygenated ( co2) blood comes

through superior and inferior vena cava and
coronary sinus.
In rt. ventricle: deoxygenated blood comes rt.
Atrium through atrio-ventricular orifice
(opening)/ tricuspid valve.
In lt. atrium: Oxygenated blood comes through
4 pulmonary veins. ( after gas exchange in lung)
In lt. ventricle: Oxygenated blood comes from
lt. atrium through atrio-ventricular orifice/
mitral valve.

Heart External Anatomy

coronary sulcus
In external side of the heart
Along the atrioventricular line ,
atrioventricular sulcus or coronary sulcus
present. coronary sinus present here.

Heart External Anatomy

Coronary Sulcus (coronary sinus present here)

Posterior Atrioventricular
(Coronary) Sulcus

Anterior atrioventricular
(Coronary) Sulcus

Great Vessels of Heart

Pulmonary Trunk carry
deoxygenated blood

Superior Vena Cavacarries deoxygenated blood

Ascending Aorta- carry

oxygenated blood

Inferior Vena Cava-carries

deoxygenated blood

Aorta & its Major Branches

Ascending Aorta

Aortic Arch

Thoracic Aorta

Aorta
Superior vena cava
Left pulmonary artery
Right pulmonary artery
Left pulmonary veins
Right pulmonary veins

Left atrium
Right atrium
Great cardiac vein
(in coronary sulcus)
Inferior vena cava
Coronary sinus
Left ventricle
Middle cardiac vein
(in posterior interventricular sulcus)

Right coronary artery

Small cardiac vein

Posterior interventricular artery

(in posterior interventricular sulcus)
Right ventricle

Apex
(c) Posterior view

20-20

2 Lt. Pulmonary Veins

2 Rt. Pulmonary Veins

Lt. Atrium

Superior Vena Cava

Inferior Vena Cava

Rt. Atrium

Great Vessels of Heart

Pulmonary Trunk

Ascending Aorta

Coronary Circulation: Artery supply of Heart

.

Ascending aorta
Superior
Right coronary artery :
vena cava
Left coronary artery :
Right
atrium
Both come from Ascending
Right coronary
aorta and give oxygen supply toartery
heart.

Pulmonary
trunk
Left atrium

Left coronary
artery

Left ventricl
Right
(a) ventricle

So, the coronary arteries

nourish the heart tissue

20-22

Coronary Arteries
Ascending aorta
Right coronary
artery
Left coronary artery

Coronary Circulation: Veins

Great cardiac vein :
small cardiac vein :
Middle cardiac vein:
Coronary sinus: All veins
empty here.

Aortic arch

Superior
vena cava

Pulmonary
trunk
Left atrium

Finally Coronary sinus with

deoxygenated blood of Heart
opens into rt. Atrium.

Right
atrium

Middle cardiac vein

Small cardiac vein

Into
right
atrium

Coronary
sinus
Great
cardiac
vein

Right ventricle
(b)

20-24

Coronary Veins

Great Cardiac V.

Small Cardiac V.

Coronary Vein Branches

Coronary Sinus

Middle Cardiac V.

Heart Chambers
Atria
Right atrium: three major veins open.
(superior vena cava, inferior vena cava,
coronary sinus)
Left atrium: four ( pulmonary veins )
vessels open, come from two lungs.

Aortic arch
Superior vena cava
Left pulmonary artery
Branches of right
pulmonary artery
Aortic semilunar valve
Right pulmonary veins

Pulmonary trunk
Left pulmonary veins
Left atrium

Pulmonary
semilunar valve

Left atrioventricular
canal

Right atrium

Bicuspid (mitral) valve

Coronary sinus

Left ventricle

Right atrioventricular canal

Chordae tendineae

Tricuspid valve

Papillary muscles

Papillary muscles

Interventricular septum

Right ventricle
Inferior vena cava

Ventricles
Right ventricle :Pulmonary trunk comes
out to lungs. (carry deoxygenated blood)
Left ventricle: Ascending aorta comes out
to body circulation (carry oxygenated blood)

20-27

Right Atrium

Opening of
coronary sinus

Opening of
superior
vena cava

Opening of
inferior vena
cava

Right
Ventricle

Rt. AV valve
Tricuspid valve

Pulmonary trunk

Left Atrium

Left Atrium

Openings of 4 pulmonary
veins

2 pulmonary veins come from each

lung with oxygenated blood and
open into Lt. atrium.

Left Ventricle
LLt. AV valve
Or bicuspid valve

Aorta and semilunar

valve

Ventricular Wall Thickness

Myocardium of Right
Ventricular Wall

Myocardium of Left
Ventricular Wall ( more thicker)

The left ventricle pumps blood through the high-resistance

systemic circulation; therefore, it has to be stronger than the
right ventricle, which pumps blood through the short lowresistance pulmonary circulation.

Valves in Heart and great vessels

Function: They enforce a one-way flow of blood
through the heart.
Valves in Heart
# AV valves- Rt. And Lt.
1. Between Rt atrium and Rt ventricle
- Rt. AV valve (tricuspid)
2. Between Lt atrium and Lt ventricle
- Lt. AV valve (bicuspid/ mitral)
Valves in vessels- Semilunar valves
1.In Pulmonary trunk 2. In ascending aorta

Valves in Heart and great vessels

Semilunar valves prevent backflow into the
ventricles ; mitral and tricuspid valves prevent
backflow into the atria .
semilunar
valve
semilunar
valve

LLt. AV valve
(bicuspid)

LRt. AV valve
(tricuspid)

Route of Blood Flow Through Heart

Superior
vena cava
Branches of
right pulmonary
arteries

Aortic arch
Left pulmonary artery
4

4
8
5

5
Pulmonary
veins

Left atrium

Pulmonary trunk
Pulmonary veins

Bicuspid valve

Right atrium
Tricuspid valve

Left ventricle

Right ventricle
Inferior
vena cava

Superior
and Inferior
vena cava

Right
atrium

Coronary sinus

Tricuspid
valve

Right
ventricl
e

Pulmonary
semilunar
valves

4
Pulmonary
Trunk

Heart tissue
(coronary
circulation)

Pulmonary
arteries

Lung tissue
(pulmonary
circulation)

Coronary
arteries

Body tissues
(systemic
circulation)

Aorta
8

Aortic
semilunar
valves

Left
ventricle

Bicuspid
valve
6

Left atrium

Pulmonary
veins
20-35

CO2

O2

Tissue
capillaries

Circulation to
tissues of head,
neck, and upper
limbs

Lung
CO2
Pulmonary
circulation
(through
lungs)

Lung
capillaries

O2

Systemic
circulation
(through body)

Left side
of heart

Right side of heart

Circulation to
tissues of
thorax, abdomen,
and lower limbs

Tissue
capillaries
CO2

O2

20-36

Pulmonary and Systemic circulation

Right atrium through the tricuspid valve to the
right ventricle through the pulmonary semilunar
valve to the pulmonary trunk, to the right and left
pulmonary arteries, to the capillary beds of the
lungs, to the pulmonary veins, to the left atrium of
the heart, through the mitral/bicuspid valve to the
left ventricle, through the aortic semilunar valve to
the aorta, to the systemic arteries, to the capillary
beds of the tissues, to the systemic veins, to the
inferior vena cava , the superior vena cava, and
coronary sinus entering the right atrium of the
heart.
20-37

Pulmonary Circulation
From right ventricle into pulmonary
trunk
Pulmonary trunk divides into left and
right pulmonary arteries.
Two pulmonary veins exit each lung
and enter left atrium
21-38

Systemic Circulation
Aorta: exits left ventricle and is divided into three
parts
Ascending aorta: right and left coronary arteries
branch from here
Aortic arch: arching posteriorly and to the left and has
three branches
Brachiocephalic artery
Left common carotid
Left subclavian artery

Descending aorta
Thoracic aorta: portion in thorax
Abdominal aorta: inferior to diaphragm. Ends as two
common iliac arteries
21-39

Conducting System

SA node: sinoatrial node. The pacemaker of Heart

AV node: atrioventricular node.
AV bundle
Right and left bundle branches:
Purkinje fibers:

# The ventricular contraction begins at the apex

and progress throughout the ventricles to the base
of the heart.
# Conducting system are Specialized cardiac
muscle Tissue.
20-40

Conducting System

SA node

AV node
AV bundle
Rt and Lt bundle branch
Purkinje fibers

20-41

Nerve supply of Heart

Autonomic nerve supply
# Sympathetic: Increase heart rate and
force of contraction.
# Parasympathetic: Decrease heart rate
and force of contraction.
Normal heart rate is, 60- 80 /min

20-42